As a hepatobiliary surgeon, almost every day I encounter people asking me, “I have gallbladder stones and I want to preserve my gallbladder to remove them, is that okay?” I have to painstakingly answer the same question over and over again every time. Now I would like to take this platform to tell you, simply summarized into one sentence: If the gallbladder is diseased it must be removed, and only consider gallbladder preservation if the gallbladder function is completely normal! 1.Why should the gallbladder be removed? When the gallbladder has stones, chronic inflammation, polyps and other diseases, it is a lesion for the human body, and if it is kept in the body, symptoms will appear at any time, such as pain in mild cases, surgery in serious cases, and in more serious cases, it may be life-threatening. The two, stones and inflammation, are mutually reinforcing. Most of the stones will have inflammation, and inflammation can promote the formation and development of stones. Besides, so far, the mechanism of gallbladder stone formation is not completely clear, that is, after the stones are removed, there is no reliable method to prevent stones and keep them from recurring, almost all patients will have stones recurring after a few years, and then they will have to do surgery again. As for polyps, especially the larger ones, they may be precancerous and should be removed. If it is chronic inflammation, the gallbladder is often no longer non-functional, the gallbladder is diseased and non-functional, or a dangerous time bomb, so why keep it? In fact, the surgery to retain the gallbladder is much simpler than removing the gallbladder, but why the majority of hepatobiliary surgery experts still do not advocate retaining the gallbladder, just because there is a hidden risk of stone recurrence by retaining the gallbladder. 2.What will happen after gallbladder removal? The normal function of the gallbladder is to store bile secreted by the liver during non-food times, concentrate it when necessary, and then contract and excrete it to the intestines when food is consumed to assist in the digestion and absorption of fats. In layman’s terms, if bile is a product, the liver is the factory of bile, the gallbladder is a warehouse of bile, and the gastrointestinal tract is the market of bile, and the warehouse is optional. Many patients suffering from gallbladder diseases, such as gallbladder stones and chronic cholecystitis, have no more warehouse function of gallbladder, but do not feel anything, so removal of gallbladder has no effect on him or her. However, if the gallbladder function is completely normal, after removing the gallbladder, due to the disharmony between eating and bile excretion, there may be steatorrhea in the first few months after the operation, that is, there may be diarrhea symptoms when eating fatty food, but the effect on the body will not be great (some cases may also be beneficial, such as the more obese, reducing the absorption of fat, which is beneficial to weight loss, huh? through its own regulation. For example, the body can adjust to: increase bile secretion when eating, and reduce or stop bile secretion when not eating; the bile duct can also be properly enlarged to store bile. Therefore, even for those with normal gallbladder function, most people with steatorrhea will disappear after a few months after gallbladder removal. Gallbladder removal has been performed for more than 100 years, and the number of gallbladder removal cases worldwide now reaches millions each year, and it has been proven to be safe and feasible. So far, for gallbladder stones and cholecystitis, the treatment principle in textbooks and professional reference books is still to remove the gallbladder, which is still the preferred method; as for some experts suggesting gallbladder preservation surgery, it is yet to be written into textbooks. 3.Is it feasible to remove gallstones with biliary preservation? As described above, in general, gallbladder stones should be removed from the gallbladder! However, if the gallbladder stones are evaluated by formal examination and there is sufficient evidence, such as cholecystography or MRI, proving that the gallbladder is completely normal and there is no inflammation or mild inflammation, the gallbladder can still be considered to be preserved. However, after gallbladder stone removal surgery, you still need to change your previous diet or take medication to prevent gallbladder stone recurrence under the guidance of your doctor. But there is still a possibility of recurrence.